遗忘型轻度认知损害患者认知功能与中医证候的相关性

doi:10.3736/jcim20090302

Abstract

Objective

To explore the correlation between the cognitive functions and syndromes of traditional Chinese medicine (TCM) in amnestic mild cognitive impairment (aMCI), and to provide evidence for clinical syndrome differentiation treatment.
Methods

Six hundred subjects from Dongzhimen Hospital and seven communities in Beijing, aged between 40 and 85 years, accepted neuropsychological assessments, imaging and biochemical examinations, and syndrome differentiation, from whom 159 aMCI patients, 213 normal control (NC) subjects and 171 Alzheimer’s dementia (AD) patients were screened out. Correlation between the cognitive functions and TCM syndromes in aMCI patients was analyzed.
Results

Mini-Mental State Examination (MMSE) score in aMCI patients was closely correlated with kidney essence vacuity and deficiency of blood and qi (r=–0.11, r=–0.11; P=0.003, P=0.015). Delayed Word Recall (DWR) score was correlated with kidney essence vacuity (r=–0.20, P=0.020). Instant Story Recall (ISR) and Delayed Story Recall (DSR) scores were respectively correlated with turbid phlegm blocking upper orifices (r=–0.11, r=–0.27; P=0.021, P=0.000). Language function was correlated with kidney essence vacuity and deficiency of blood and qi (r=–0.11, r=–0.13; P=0.042, P=0.007). Attention/calculation was also closely correlated with kidney essence vacuity and deficiency of blood and qi (r=–0.10, r=–0.21; P=0.039, P=0.010). Attention score of aMCI patients was correlated with excess of heat toxin syndrome (r=–0.29, P=0.026).
Conclusion

The memory decline of aMCI is correlated with kidney essence vacuity and turbid phlegm blocking upper orifices. Furthermore, turbid phlegm blocking upper orifices is correlated with episodic memory decline, which is closely related to AD. The aMCI patients with phlegm have the risk to progress into AD. Although other cognitive functions of aMCI remain relatively intact, the patients’ language function, attention/calculation and the whole cognitive function may be worsen as the aggravation of kidney essence vacuity, deficiency of blood and qi, phlegm and heat toxin, and may eventually lead to multiple cognitive domains impairment, even dementia.

Key words: Amnestic mild cognitive impairment, Cognitive functions, Syndromes in traditional Chinese modicion, Corrolation

Ying-chun Miao , Jin-zhou Tian , Jing Shi , Min Mao , Xiao-dong Zhao , Li-yan Fang , Chui-you Zeng , Jian-ping Liu , Zhi-liang Wang , Xiao-bin Li. Correlation between cognitive functions and syndromes of traditional Chinese medicine in amnestic mild cognitive impairment. Journal of Chinese Integrative Medicine, 2009, 7(3): 205-211.

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URL: http://www.jcimjournal.com/EN/10.3736/jcim20090302

http://www.jcimjournal.com/EN/Y2009/V7/I3/205

[1]	Petersen RC . Mild cognitive impairment: transition between aging and Alzheimer's disease[J]. Neurologia, 2000,15(3):93-101
[2]	Ritchie K, Touchon J . Mild cognitive impairment: conceptual basis and current nosological status[J]. Lancet, 2000,355(9199):225-228 doi: 10.1016/S0140-6736(99)06155-3
[3]	Hanninen T, Hallikainen M, Tuomainen S, Vanhanen M, Soininen H . Prevalence of mildcognitive impair-ment: a population-based study in elderly subjects[J]. Acta Neurol Scand, 2002,106(3):148-154
[4]	Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E . Mild cognitive impairment: clinical characterization and outcome[J]. Arch Nerol, 1999,56(3):303-308 doi: 10.1001/archneur.56.3.303
[5]	Busse A, Bischkopf J, Riedel-Heller SG, Angermeyer MC . Subclassifications for mild cognitive impairment: prevalence and predictive validity[J]. Psychol Med, 2003,33(6):1029-1038 doi: 10.1017/S0033291703007839
[6]	Petersen RC, Thomas RG, Grundman M, Bennett D, Doody R, Ferris S, Galasko D, Jin S, Kaye J, Levey A, Pfeifer E, Sano M, van Dyck CH, Thal LJ; Alzheimer’s Disease Cooperative Study Group .Vitamin E and donepezil for the treatment of mild cognitive impairment[J]. N Engl J Med, 2005,352(23):2379-2388 doi: 10.1056/NEJMoa050151
[7]	Clinical trial: Institute on Aging. Memory impairment study (mild cognitive impairment study)[2007-05-24]. .
[8]	Clinical trial: Nicotine treatment of mild cognitive impairment[2007-05-24]. .
[9]	McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM . Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease[J]. Neurology, 1984,34(7):939-944 doi: 10.1212/WNL.34.7.939
[10]	Tian JZ, Shi J, Zhang XQ, Bi Q, Ma X, Wang ZL, Li XB, Sheng SL, Li L, Wu ZY, Fang LY, Zhao XD, Miao YC, Wang PW, Ren Y, Yin JX, Wang YY . Guiding principles of clinical research on mild cognitive impairment(protocol)[J]. J Chin Integr Med, 2008,6(1):9-14
	田金洲, 时晶, 张新卿, 毕齐, 马辛, 王志良, 李晓斌, 盛树力, 李林, 吴振云, 房立岩, 赵晓东, 苗迎春, 王蓬文, 任映, 尹军祥, 王永炎 . 轻度认知损害临床研究指导原则(草案)[J]. 中西医结合学报, 2008,6(1):9-14
[11]	11Howieson DB, Dame A, Camicioli R, Sexton G, Payami H, Kaye JA, Chen GZ . Cognitive signs of healthy elderly population preceding Alzheimer’s dementia[J]. Shi Jie Yi Xue Za Zhi, 1998,2(3):24-28
	Howieson DB, Dame A, Camicioli R, Sexton G, Payami H, Kaye JA, 陈国璋 .健康老年人阿耳茨海默痴呆前的认识标记[J]. 世界医学杂志, 1998,2(3):24-28
[12]	Aggarwal NT, Wilson RS, Beck TL, Bienias JL, Bennett DA . Mild cognitive impairment in different functional domains and incident Alzheimer’s disease[J]. J Neurol Neurosurg Psychiatry, 2005,76(11):1479-1484 doi: 10.1136/jnnp.2004.053561
[13]	Tian JZ, Yang CZ, Sheng T, Liu H . The correlation of characters of cognitive impairment preceding Alzheimer’s dementia in individuals with questionable dementia to Chinese medical syndrome[J]. Hubei Zhong Yi Xue Yuan Xue Bao, 1999,1(4):49-54
	田金洲, 杨承芝, 盛彤, 刘桓 . 可疑痴呆人群中阿尔茨海默病临床前的认知损害特征及其与中医证候关系[J]. 湖北中医学院学报, 1999,1(4):49-54
[14]	Kuller LH, Shemanski L, Manolio T, Haan M, Fried L, Bryan N, Burke GL, Tracy R, Bhadelia R . Relationship between ApoE, MRI findings and cognitive function in the Cardiovascular Health Study[J]. Stroke, 1998,29(2):40-46 doi: 10.1161/01.STR.29.1.40
[15]	Wehr H, Parnowski T, Puzyński S, Bednarska-Makaruk M, Bisko M, Kotapka-Minc S, Rodo M, Wolkowska M . Apolipoprotein E genotype and lipid and lipoprotein levels in dementia[J]. Dememt Geratr Cogn Disord, 2000,11(2):70-73 doi: 10.1159/000017217
[16]	Sheng SL. Alzheimer’s disease: from molecular biology to clinical diagnosis and treatment[M]. Beijing: Scientific and Technical Documents Publishing House,1998: 128-138
	盛树力 . 老年性痴呆: 从分子生物学到临床诊治(北京)[M]. 北京: 科学技术文献出版社, 1998,( 北京):128-138

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Syndrome	TCM syndrome score
Syndrome	NC group (n=213)	aMCI group (n=159)	AD group (n=171)
Kidney essence vacuity	10.60±3.24	11.61±2.65*	12.78±3.40**^△
Turbid phlegm blocking upper orifices	10.18±3.35	11.94±2.90**	12.23±3.18**
Blood stasis obstructing brain collaterals	8.95±1.93	9.88±2.73*	10.30±1.94*
Hyperactivity of yang due to yin deficiency	9.88±2.73	9.22±2.34	9.96±2.42
Deficiency of blood and qi	8.67±1.63	9.55±2.68	8.92±2.51
Excess of heat toxin	9.41±3.70	9.50±3.31	9.14±2.91
Viscera stagnation and turbid left	9.14±2.91	9.40±3.06	10.43±2.87

Syndrome	n	Correlation coefficient
Syndrome	n	MMSE	ISR	DSR	MoCA	HVLT	CDT
Kidney essence vacuity	159	–0.11**	–0.14	–0.06	–0.08	–0.19	0.02
Turbid phlegm blocking upper orifices	159	–0.06	–0.11*	–0.27**	0.23	0.03	–0.01
Blood stasis obstructing brain collaterals	159	–0.01	–0.10	–0.05	–0.01	–0.12	–0.11
Hyperactivity of yang due to yin deficiency	159	0.19	–0.02	0.03	–0.20	–0.03	0.03
Deficiency of blood and qi	159	–0.04*	–0.09	–0.03	–0.05	–0.10	0.07
Excess of heat toxin	159	–0.02	–0.02	–0.10	–0.04	–0.09	0.11
Viscera stagnation and turbid left	159	–0.11	–0.01	–0.10	–0.13	–0.03	–0.08

Syndrome	n	Correlation coefficient
Syndrome	n	IWR (MMSE)	DWR (MMSE)	DWR (MoCA)	HVLT
TKidney essence vacuity	159	–0.09	–0.10	–0.20*	–0.19
Turbid phlegm blocking upper orifices	159	0.01	–0.08	0.10	0.03
Blood stasis obstructing brain collaterals	159	0.07	–0.02	–0.18	–0.12
Hyperactivity of yang due to yin deficiency	159	–0.02	0.09	–0.24	–0.03
Deficiency of blood and qi	159	0.02	–0.04	–0.13	–0.10
Excess of heat toxin	159	0.03	0.02	–0.14	–0.09
Viscera stagnation and turbid left	159	0.05	–0.12	–0.03	–0.03

Syndrome	Correlation coefficient
Syndrome	n	ISR	DSR
Kidney essence vacuity	159	–0.14	–0.06
Turbid phlegm blocking upper orifices	159	–0.11*	–0.27**
Blood stasis obstructing brain collaterals	159	–0.10	–0.05
Hyperactivity of yang due to yin deficiency	159	–0.02	0.03
Deficiency of blood and qi	159	0.09	–0.03
Excess of heat toxin	159	–0.02	–0.10
Viscera stagnation and turbid left	159	–0.01	–0.10

Cognitive function	Correlation coefficient
Cognitive function	Kidney essence vacuity	Turbid phlegm blocking upper orifices	Blood stasis obstructing brain collaterals	Hyperactivity of yang due to yin deficiency	Deficiency of blood and qi	Excess of heat toxin	Viscera stagnation and turbid left
Language
MMSE	–0.11*	–0.02	0.11	0.10	–0.13**	–0.04	0.11
MoCA	–0.06	0.21	0.13	–0.08	–0.06	–0.13	–0.05
Attention/calculation
MMSE	–0.10*	0.01	0.03	0.03	–0.21*	0.02	–0.09
MoCA	–0.09	0.22	0.09	–0.10	–0.19	–0.29*	–0.09
Abstraction
MoCA	0.14	0.01	0.03	0.08	–0.04	0.03	–0.02
Visuospatial and executive function
MoCA	0.02	0.08	0.13	–0.15	–0.06	–0.08	–0.07
CDT	0.02	–0.01	–0.11	0.03	–0.08	0.07	0.11
Orientation
Time	–0.12	0.03	0.02	0.15	–0.05	–0.02	0.07
Place	0.03	0.11	0.01	–0.03	0.01	–0.13	–0.08
Total	0.08	0.08	0.05	0.07	–0.06	0.13	–0.01

Correlation between cognitive functions and syndromes of traditional Chinese medicine in amnestic mild cognitive impairment

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